University of Tampere Medical School, FI-33014 University of Tampere, and Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
Euro Surveill. 2011 Sep 1;16(35):19958.
Meticillin-resistant Staphylococcus aureus (MRSA) has emerged as a frequent pathogen in blood cultures in Pirkanmaa Hospital District (HD), Finland. To study risk factors for MRSA bacteraemia and the adequacy of empirical antimicrobial treatment, we retrospectively reviewed the hospital records of 102 patients, 51 with MRSA, and 51 with meticillin-sensitive Staphylococcus aureus (MSSA) bacteraemias respectively, who had been admitted to Tampere University Hospital in Pirkanmaa HD, from October 2002 to January 2010. For each patient with MRSA bacteraemia, one consecutively detected unmatched patient with MSSA bacteraemia was chosen as control. Patients with MRSA bacteraemias were significantly older (median age: 73 years vs 59 years, p=0.001), were more likely to have been transferred directly from another healthcare facility or were already in the hospital at the onset of bacteraemia (39/51 vs 26/51, p=0.007) and had a higher McCabe class than patients with MSSA bacteraemia (p=0.005). Patients with MRSA bacteraemia more seldom received adequate empirical antimicrobial therapy when compared to those with MSSA bacteraemia (13/51 vs 43/51, p<0.001). Of previously known MRSA carriers 10 of 29 received adequate empirical antimicrobial therapy for their condition. The percentage of MRSA bacteraemias among all S. aureus bacteraemias in Pirkanmaa HD is high compared to corresponding figures for the whole of Finland.
耐甲氧西林金黄色葡萄球菌（MRSA）已成为芬兰皮卡拉区（HD）医院血培养中常见的病原体。为了研究 MRSA 菌血症的危险因素和经验性抗菌治疗的充分性，我们回顾性地审查了皮卡拉 HD 坦佩雷大学医院 2002 年 10 月至 2010 年 1 月期间收治的 102 例患者的医院记录，其中 51 例为 MRSA 菌血症，51 例为耐甲氧西林金黄色葡萄球菌（MSSA）菌血症。对于每例 MRSA 菌血症患者，选择一名连续检测到的 MSSA 菌血症患者作为对照。MRSA 菌血症患者的年龄明显较大（中位数年龄：73 岁比 59 岁，p=0.001），更有可能直接从另一家医疗机构转来或在菌血症发病时已经住院（39/51 比 26/51，p=0.007），且 McCabe 分级高于 MSSA 菌血症患者（p=0.005）。与 MSSA 菌血症患者相比，MRSA 菌血症患者经验性抗菌治疗更不充分（13/51 比 43/51，p<0.001）。在已知的 29 例 MRSA 携带者中，有 10 例对其病情接受了充分的经验性抗菌治疗。与整个芬兰相比，皮卡拉区的所有金黄色葡萄球菌菌血症中，MRSA 菌血症的比例较高。
